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  • P.O. Box 1555, Montclair NJ 07042

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What is the role of a Nurse Case Manager in New York State Workers’ Compensation?

A nurse case manager (NCM) plays a key role in coordinating medical care for injured workers while ensuring cost-effective treatment and compliance with Workers’ Compensation guidelines. Their primary responsibilities include:

While NCMs may offer recommendations, they do not make medical decisions, and their role must adhere to NY Workers’ Compensation Board (WCB) regulations, ensuring that the injured worker's rights are protected.

Involving a NCM at the onset of the claim can lead to a better outcome with speedier recoveries and the potential for the claimant to return to work. A NCM interfacing with the claimant – with the consent of counsel if the claimant is represented – is important to show the claimant that someone cares and can listen to their concerns about medical treatment and recovery.

Let Asch Workers’ Comp Strategy assist you in getting started with NCMs.

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How We Work

Our Process

Communication

Nurse case managers are the bridge between the medical and legal aspects of a claim. Their communication with injured workers, physicians, employers, and adjusters ensures everyone is on the same page regarding treatment plans and return-to-work goals.

Coordination

They coordinate medical care, appointments, and authorizations, often expediting treatment and reducing delays. Their involvement can significantly impact the claim’s trajectory by ensuring appropriate and timely care.

Reporting

Nurse case managers document all progress and setbacks in treatment, providing reports that inform claims decisions and can be used to support or challenge disability determinations. Their records also serve as a key part of trial preparation and case valuation.

Early intervention could get the claimant back to work sooner

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